Overwhelming postoperative streptococcal infection

Fulminant postoperative group A beta-hemolytic streptococcal infections present a serious and potentially lethal threat to children. Three children with severe postoperative streptococcal wound infections are presented. Each child developed high fever within the first 24 hr after surgery, followed shortly by signs of septic shock. In all patients, the clinical appreciation of wound infection became apparent late in the course of the illness. All three children had white blood cell counts below 6000/cu mm. One child developed crepitus in the incision; another showed radiographic evidence of free air in the soft tissues. The only survivor received antibiotics immediately following the initial fever along with re-exploration and drainage of the operative wound.